Hollow Eyes and Tear Trough Fillers – by Dr. Sabrina Shah-Desai, Leading Oculoplastic Surgeon

As we age, we lose volume in the tear trough (under-eye) region. This causes dark circles, wrinkles, thinning skin and under-eye hollows to appear, making us look tired. This ageing change can start as early as our late twenties and can cause a lot of distress when we look in the mirror.

Tear trough fillers are an effective way to treat dark circles under the eyes and under-eye hollows. By injecting filler under the eyes, we fill the volume lost by ageing – lightening dark circles, filling under eye hollows and wrinkles. This treatment also improves skin quality by boosting collagen production and hydrating skin from the inside.
Oculoplastic Surgeon Dr Shah-Desai has over 20 years of experience injecting in this area and teaches doctors from all over the world in how to deliver safe, effective and natural-looking tear trough results.

She has pioneered the Eye-Boost™ technique – which takes a 360 approach to rejuvenating tired eyes. This treatment volumises pronounced tear troughs, plumps hollows and rejuvenates the under-eye zone by precisely injecting a hyaluronic acid based dermal filler along the skin of the lower eyelid and tear trough.

• Painless – topical anaesthetic is applied
• Long-lasting results – 6 months to a few years
• Quick – typically takes 15 minutes with little downtime

Yes – tear trough fillers are an excellent way to treat dark circles, eye bags and under-eye hollows. If your eye bags are moderate to severe (more than you can see in our before and after pictures) you may want to consider a blepharoplasty.

How The Peri-orbital Area Ages

The dermal fillers we use are made from hyaluronic acid – a substance that occurs naturally in the body. These types of fillers are biodegradable, which means that they will gradually be absorbed as the gel breaks down and water takes its place. When totally absorbed, the filler gel disappears unnoticed from the body.

Most patients retain their results from 6-18 months, however precisely how long a tear trough treatment holds its effect is very individual. This depends on many factors, such as your age, skin type, lifestyle, and muscle activity. For moderate to severe eye bags you should consider eye bag removal surgery – which gives results lasting 10 years of more.

We apply a topical anaesthesia under the eyes for 15 minutes before your treatment, meaning that the tear trough filler injections are virtually painless. The fillers themselves also contain an anaesthetic to make the treatment more comfortable.

First, we take your photo, in order to give you a comparison for before and after your treatment. The team then applies a topical anaesthetic and leaves it to numb your eyelid skin for several minutes. Dr Sabrina then precisely injects filler under the skin in tiny aliquots with a very thin needle/canula which takes around 15 minutes. Dr. Sabrina will then analyse how the filler is reducing your volume deficiency and dark circles and add more filler to certain areas if necessary. She then gives you specialist skincare advice to help protect and maintain the delicate under-eye skin

The treatment usually takes less than 15 minutes and you can see an initial result from the tear trough fillers immediately. Often the treatment causes a very subtle swelling, so although the area will instantly look more filled, we advise waiting a week to see the final result of the treatment. If you have a pigment problem with your under-eyes as well as a tear trough deficiency you will need a bespoke skincare regime to reduce this pigmentation too. In this case you’ll see an instant improvement from the fillers (which will improve shadowing and thin skin issues), but it will take several weeks to improve the pigment issue.

We’ve all seen celebrities that have ‘filler faces’ with puffy cheeks who don’t look like themselves anymore.

This is what happens when a practitioner has placed too much filler in the wrong places, without understanding facial anatomy.

Fillers are simply products used to replace the volume we lose in our faces as we age. If done subtly and in proportion to the patient’s natural beauty, you will have natural-looking, age-appropriate results.

Tear trough fillers can take a few weeks to settle. If after this period you don’t like them, they be dissolved by injecting hyaluronidase, which takes less than 24 hours to work. That means if you’re ever unhappy with the result, it’s quick and easy to go back to your normal self.

There’s negligible downtime after tear trough fillers – most people can go back to work immediately after your treatment. Bear in mind that some patients experience bruising and mild swelling (although others don’t) so it’s best to leave two weeks before any important social events.

Here’s an image of a patient’s recovery after tear trough fillers. You can see some mild swelling and bumpiness in the second picture.

Bruises and lumps sometimes occur and are usually visible for 3-7 days. They can be effectively covered up by mineral makeup. Our philosophy is natural -looking results and this treatment is undetectable once any swelling or bruising has settled down.

Tear trough fillers recovery time

• Have a known allergy to the product or lidocaine
• Have an active infection at site of injection
• Have alcohol in your system: the injections are more likely to give you bruises
• Are pregnant
• Are breastfeeding

Ellansé is an excellent gradual collagen stimulator and Morpheus8 is a micro-needling/radiofrequency combination treatment that tightens loose skin. 

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